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phy, weak muscles, and weak feet. When scien- tifically applied they do relieve pain and a ten- dency to deformity, as immediately after re- moving corrective plaster of Paris. They should be discarded as soon as their primary object is attained, a s constant wearing sacrifices mo- bility and strength. In regard to the prescribing of foot plates and therapeutic shoes by shoe clerks, the medical profes- sion has been exceedingly remiss as New Cialis Rx Index a guardian of public heaUIi. The uncalled for application of plates and modified shoes has been the cause of many aggravated weak feet conditions that will persist through life. The laxity on the part of the tnedical profession is due to the fact that the average physician is wofully lacking in the most elementarv knowledge concerning the treatment of foot conditions. Most of them have made a very superficial studv of orthopedics in general, New Cialis Rx Index and never having gone deeply enough into the subject have no idea of its ramifications and its relation to internal medicine. Almost every pain in the foot or discomfort produced by a foot working at a me- chanical disadvantage is diagnosed as rheumatism, and the patient is given salicylates, or is sent to a shoe store or a bracemaker for New Cialis Rx Index a foot plate. \\'ith just as much scientific attainment and medical ception of a well fitting and correct weight bearing position. A very good example of the appearance of the foot in a poorly balanced shoe. When trj-ing on a shoe remem- ber that a shoe that disturbs the balance, gives a sensation of turning the foot outward and po'irig the outer side of the foot upward, no matter how good the design, will com- pel your foot to work at a mechanical disadvantage. Such a shoe should New Cialis Rx Index be modified or discarded. B, a properly bal- anced foot (after Whitman). I'HSKI.W: CALCULI JX THE LRISARY BLADDER 1 New Vo»k Medical Joonal acumen could the doctor send a trusting patient with heart disease to the druggist with a note directing that he be given a heart brace, the drug- gist to decide as to the dose, duration of treatment, and whether to administer digitalis, strychnine, or what not. Another physician will call up his orthopedic acquaintance and inquire the name of a shoemaker or the shoe that he recommands, and sends his suffering ]jatient to be dosed by this skilled mechanic. The erudite few direct the skilled mechanic to select his most approved crea- tion and cant the heel or sole or both by one eighth to one fourth inch, or apply a brace, or foot prop, which the doctor has designed and declares meets every condition to which the foot is heir. Another group of the ])rofession considers the chiropodist fills the long New Cialis Rx Index felt want, and these men and women are making wonderful strides in their preparation and aspiration to be doctors of the foot, as though it were possible to treat intelligently a single part of the body. These remarks are not made in a spirit of levity or of comj)laint, but as a warning to the self suf- ficient that the medical profession as a whole is passing along, to men less generally and broadly prepared, the care of that part of the body which many of the best tacticians declare decides the battle or the campaign, a part so intimately related in function and pathology as to brook no separation in treatment. REFERENCE.S. !. WHITMAN: Systematic Manipulation, 5th edition, p. 721. 4. IIERBEUT C. New Cialis Rx Index CLARK: Etiological Factors in Gross Lesions of the New Cialis Rx Index I.arRc Joints, Journal A. M. A.. December 22, 1917. 5. E. E. SMITIl: Clinical Significance of Gastrointestinal Toxemias, New \'oRK Medical Journal, July 28, 1917; H. AUTHELAIN: New York Medical Journal, December 29, 1917. CALCULI IN THE URINARY BLADDER. Report of an Unusual Case. By Arnold Peskind, M. D.. Qeveland. Casi-:. — Mr.s. \i.. seventy-two years of age, the motlier New Cialis Rx Index of five living children, arrived at the Kast Fifty-fifth Street Hospital August 4, 1917, suflfering from complete retention of urine since June 24th, from which date the catheter had to be resorted to. She had undergone several operations on the uterus and its annexa, and these were totally re- moved about ten years ago. She had also suffered many attacks of gallstone colic, often accompanied by jaundice of variable intensity and duration. The last, a very severe attack, about a year ago, was accompanied by chills nd fever, followed by jaundice lasting several weeks and only subsided when the softened stone ulcerated into the duod- cnurrf and was expelled through the bowels. For the past few years Mrs, E, had been suffering from myocarditis and bronchial asthma. There was also a hard round swelling in the right breast, involving its lower half, adherent to the skin, with nipple markedly retracted. It was somewhat nodular, but New Cialis Rx Index no .glands New Cialis Rx Index were perceptibly involved. It was undoubtedly a slowly .growing scirrhous carcinoma, not in- frequently met with in practice, which seldom causes any serious metastasis. She was advised some time before to liave the tumor removed, but this she flatly refused, as it did New Cialis Rx Index not cause her much inconvenience nor any pain. There